AHRQ Resource Guide Aids Alaska Diabetes Self-Management Program

Alaska's Division of Public Health and Alaska Medicaid have initiated the design of a disease management program, an endeavor that was inspired in part by AHRQ's Diabetes Care Quality Improvement: A Resource Guide for State Action. AHRQ research was instrumental in convincing Alaska health planners that diabetes costs could be reduced.

Soon after reading the AHRQ diabetes care materials in early 2005, Barbara Stillwater, PhD, RN, compiled a data set related to diabetes costs for her department's Diabetes Prevention and Control Program. "AHRQ's document was pivotal in two ways," Stillwater notes. "First, it provided a source of background data, and second, it provided formulas for calculating the direct and indirect costs of diabetes. These data and analyses were included in the Alaska Diabetes Strategic Plan for 2010."

Particularly notable were the data showing the following:

Diabetes is the sixth most costly medical condition in the U.S.

Nearly 14 percent of the total national Medicaid budget is allocated to persons with diabetes, although only slightly more than 4 percent of all Medicaid recipients has diabetes.

Cases of diabetes have significantly increased over the past 10 years in Alaska.

Diabetes costs are primarily driven by the treatment of complications, which are largely preventable with early diagnosis and treatment.

Health care costs are disproportionately high in Alaska.

Diabetes is one of the top causes of death in Alaska.

Alaska's directors of Public Health and Health Care Services convened a meeting to discuss the chronic care model. In a continued effort to advocate for disease management, Stillwater's group did an analysis of the State Medicaid data and published it on their diabetes Web page for dissemination to program planners and researchers.

"The data were pretty compelling," Stillwater says. "We used these data as leverage for discussions with health department officials. As a result, we have been asked to help make recommendations on how to incorporate disease management into our public health care system." Subsequently, Stillwater participated in a meeting with the directors of Alaska Medicaid, the Director of Public Health, and the Coordinator of the Alaska Heart Disease and Stroke Program.

Alaska Medicaid has convened an interagency steering committee to design and direct the development of Medicaid disease management programs. In addition, a recent legislative review of the Medicaid program recommended that Alaska Medicaid explore the development of disease management programs.